NPI | 1609335470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0071146) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0071146) |
208000000X Pediatrics (Licence: CO DR.0071146) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2023-08-09 |